Anti-TNFs and self-injecting worries

I’m back, after over two months of absence. I’m sorry I’m such a terrible blogger – it’s really crept up on me, just how busy I am writing a weekly blog elsewhere and doing a full time degree. Even my three weeks off for Easter have been spent doing reading and freaking out about how I’m going to find 12 stories to write for my end of year assessments. But that’s all for me to deal with and not you.

The reason for my return is some breaking news on the medicine front. Cue DMARD sirens – *wooooo wooooo woooo* – I’M OFF SULFASALAZINE AND I’M GOING TO BE PUT ON A NEW DRUG!

Yes, after a year of extremely effective arthritis thrashing, I’ve decided that tri-annual temporary liver damage is not for me. I’ve written about two previous occasions when my ALT results (a test of liver function done in blood tests) have been raised above the expected boundary, and I have had to stop my medicine and drinking alcohol for two weeks until they returned to normal. These two occasions previously coincided with occasions where I happened to drink a lot, and it was thought that this might have swayed the results slightly.

Until this most recent blood test, where I behaved myself in order to avoid stopping my medication. It was all pointless, as my ALT results had gone even higher and so I asked that I just change drugs. The real big news is that I’m going to be put onto an anti-TNF drug, which is different to conventional DMARDs such as methotrexate and sulfasalazine.

Anti-TNF (Tumour Necrosis Factor) drugs – a type of biological therapy – block the action of the TNF protein, which is overproduced in the bodies of people with inflammatory diseases, causing the inflammation and damage to joints and other tissues of people with arthritis. Biological therapies are still a type of DMARD , so they target the cause of arthritis rather than treat its symptoms, but they target molecules that cause inflammation.

I’ve been on an anti-TNF drug before, etanercept, which is what my rheumatologist is considering putting me on now. I’ve been wanting to write about etanercept (because of my four years on it 2003-2007) since I started this blog, and this seems like a perfect occasion to do so. Sometimes etanercept is only effective with a conventional DMARD as well, and when I was on it before I had to take methotrexate as well. This was also during my six years on growth hormone and my aversion to tablets, so for three glorious years my mum was injecting me in my legs 10 times a week. I still have the dents.

Because I’m starting a new drug, I’ve been instructed to allow three hours for my appointment on Wednesday. You can’t take etanercept if you’ve ever been exposed to TB or hepatitis so I need to have a chest X-ray, screening and blood test to check.

The scariest part for me is the idea of self-injecting. Though I’m not afraid of injections, any time I have had one at home my mum has always done it. But I don’t live with my mum anymore, and I’m not sure my flatmate is a) allowed to do it; and b) up for it. I’m just a bit frightened of injecting myself, but also worried that I might not be able to. My hands aren’t the best or the steadiest (arguably why I’m going on the drug in the first place) so what if I can’t do it?